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Effects of the COVID-19 pandemic on secondary care for cardiovascular disease in the UK: an electronic health record analysis across three countries

F L Wright, Kate Cheema, Raph Goldacre, Nick Hall, Naomi Herz, Nazrul Islam, Zainab Karim, David Moreno-Martos, Daniel R Morales, Daniel O'Connell, Enti Spata, Ashley Akbari Orcid Logo, Mark Ashworth, Mark Barber, Norman Briffa, Dexter Canoy, Spiros Denaxas Orcid Logo, Kamlesh Khunti, Amanj Kurdi Orcid Logo, Mamas Mamas Orcid Logo, Rouven Priedon, Cathie Sudlow, Eva J A Morris, Ben Lacey, Amitava Banerjee Orcid Logo

European Heart Journal - Quality of Care and Clinical Outcomes, Volume: 9, Issue: 4

Swansea University Author: Ashley Akbari Orcid Logo

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DOI (Published version): 10.1093/ehjqcco/qcac077

Abstract

BackgroundAlthough morbidity and mortality from COVID-19 have been widely reported, the indirect effects of the pandemic beyond 2020 on other major diseases and health service activity have not been well described.Methods and resultsAnalyses used national administrative electronic hospital records i...

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Published in: European Heart Journal - Quality of Care and Clinical Outcomes
ISSN: 2058-5225 2058-1742
Published: Oxford University Press (OUP) 2022
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa62054
Abstract: BackgroundAlthough morbidity and mortality from COVID-19 have been widely reported, the indirect effects of the pandemic beyond 2020 on other major diseases and health service activity have not been well described.Methods and resultsAnalyses used national administrative electronic hospital records in England, Scotland, and Wales for 2016–21. Admissions and procedures during the pandemic (2020–21) related to six major cardiovascular conditions [acute coronary syndrome (ACS), heart failure (HF), stroke/transient ischaemic attack (TIA), peripheral arterial disease (PAD), aortic aneurysm (AA), and venous thromboembolism(VTE)] were compared with the annual average in the pre-pandemic period (2016–19). Differences were assessed by time period and urgency of care.In 2020, there were 31 064 (−6%) fewer hospital admissions [14 506 (−4%) fewer emergencies, 16 560 (−23%) fewer elective admissions] compared with 2016–19 for the six major cardiovascular diseases (CVDs) combined. The proportional reduction in admissions was similar in all three countries. Overall, hospital admissions returned to pre-pandemic levels in 2021. Elective admissions remained substantially below expected levels for almost all conditions in all three countries [−10 996 (−15%) fewer admissions]. However, these reductions were offset by higher than expected total emergency admissions [+25 878 (+6%) higher admissions], notably for HF and stroke in England, and for VTE in all three countries. Analyses for procedures showed similar temporal variations to admissions.ConclusionThe present study highlights increasing emergency cardiovascular admissions during the pandemic, in the context of a substantial and sustained reduction in elective admissions and procedures. This is likely to increase further the demands on cardiovascular services over the coming years.
College: Faculty of Medicine, Health and Life Sciences
Funders: The British Heart Foundation Data Science Centre (grant No SP/19/3/34 678, awarded to Health Data Research (HDR) UK) funded co-development (with NHS Digital) of the TRE, provision of linked datasets, data access, user software licences, computational usage, and data management and wrangling support with additional contributions from the HDR UK Data and Connectivity component of the UK Government Chief Scientific Adviser’s National Core Studies programme to coordinate national covid-19 priority research. Consortium partner organisations funded the time of contributing data analysts, biostatisticians, epidemiologists, and clinicians. This work was supported by the Con-COV team funded by the Medical Research Council (grant number: MR/V028367/1). This work was supported by Health Data Research UK, which receives its funding from HDR UK Ltd (HDR-9006) funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF) and the Wellcome Trust. This work was supported by the ADR Wales programme of work, aligned to the priority themes 410 as identified in the Welsh Government’s national strategy: Prosperity for All. ADR Wales brings together data science experts at Swansea University Medical School, staff from the Wales Institute of Social and Economic Research, Data and Methods (WISERD) at Cardiff University and specialist teams within the Welsh Government to develop new evidence which supports Prosperity for All by using the SAIL Databank at Swansea University, to link and analyse anonymised data. ADR Wales is part of the Economic and Social Research Council (part of UK Research and Innovation) funded ADR UK (grant ES/S007393/1). This work was supported by the Wales COVID-19 Evidence Centre, funded by Health and Care Research Wales.
Issue: 4

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